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Permit • • CITY OF TIGARD �, SEWER CONNECTION PERMIT `' Is COMMUNITY DEVELOPMENT Permit #: SWR2013 -00003 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2013 Parcel: 2S109DA14400 Jurisdiction: Tigard Site address: 15211 SW GREENRIDGE PL Project: Arlington Heights, Lot 63 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 63 Project Description: Sewer connection for new SF. 2/4/13, reprint to correct intake date, EDU count and job description. Contractor: Owner: STONE BRIDGE HOMES NW 16869 SW 85TH AVE #505 LAKE OSWEGO, OR 97035 • PHONE: PHONE: 503 - 387 -7577 FAX: • FEES Description Date Amount Specifics: Sewer Connection Fee 01/28/2013 $4,665.00 Sewer Inspection - Residential 01/28/2013 $35.00 Type of Use: SF Class of Work: NEW Install Type: Line Tap and Building Sewer Fixture Units: Number of Dwelling Units: 1 Total $4,700.00 Required Items and Reports (Conditions) • This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is sus•en•e• or • e the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. ose rules are s= forth OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dir ct questions to OUN by callin! 503.232.19' 1.800.. .2344. Issu • By: / // // / Permittee Signat e: 6 Call 503.639.4175 by 7:00 a.m. for the next available inspectie ate. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. v CITY OF TIGARD SEWER CONNECTION PERMIT IL t 11 :j. COMMUNITY DEVELOPMENT Permit #: SWR2013 00003 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2013 Parcel: 2S 109DA14400 Jurisdiction: Tigard Site address: 15211 SW GREENRIDGE PL Project: Arlington Heights, Lot 63 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 63 Project Description: New SF Contractor: Owner: STONE BRIDGE HOMES NW 16869 SW 85TH AVE #505 LAKE OSWEGO, OR 97035 PHONE: PHONE: 503 - 387 -7577 FAX: . FEES Description Date Amount Specifics: Sewer Connection Fee 01/28/2013 $4,665.00 Sewer Inspection - Residential 01/28/2013 $35.00 Type of Use: Class of Work: Install Type: Fixture Units: Number of Dwelling Units: Total $4,700.00 ` Required Items and Reports (Conditions) ` This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by - = mg 50 . - .1987 or 1.800.332.2344. Issued = : + /_i Permittee Signature: (///'(�-- Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection.